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MRCP Part 1 > Opthalmology > Flashcards

Opthalmology Flashcards

1
Q

Causes of acute red eye

A 
Acute angle closure glaucoma
Anterior uveitis
Conjunctivitis
Scleritis
Epi-scleritis
Subconjunctivial haemorrhage
Endophalmitis
Keratitis
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2
Q

S+S acute angle closure glaucoma

A 
Severe pain (ocular or headache)
Decreased visual acuity
Patient sees halos
Semi dilated pupil 
Hazy cornea
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3
Q

S+S anterior uveitis

A 
Acute onset
Pain
Blurred vision
Photophobia
Small fixed oval pupil
Ciliary flush
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4
Q

S+S scleritis

A

Severe pain - worse on eye movements
Tenderness
May be underlying AI condition eg. RA

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5
Q

Most common causes of orbital/periorbital cellulitis

A

Streptococcus
Staph. aureus
Haemophillus influenzae B

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6
Q

Causes of sudden painless visual loss

A 
Ischaemic optic neuropathy
Central retinal vein occlusion
Central retinal artery occlusion
Vitreous haemorrhage
Retinal detachment
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7
Q

S+S ischaemic optic neuropathy

A

Altitudinal visual field defects

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8
Q

S+S central retinal vein occlusion

A

Sever retinal haemorrhages on fundoscopy

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9
Q

S+S vitreous haemorrhage

A

Large -> sudden visual loss
Medium -> several dark spots
Small -> floaters

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10
Q

S+S central arterial occlusion

A

Afferent pupillary defect

Cherry red spot on pale fundus

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11
Q

S+S retinal detachment

A

Curtain/veil over vison (from peripheral to central)
Straight lines become curved
Central visual loss

Often preceded by posterior vitreous detachment

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12
Q

S+S vitreous detachment

A

Flashes in peripheries

Floaters - commonly in temporal area

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13
Q

S+S keratitis

A

Red painful eye, photophobia, FB/gritty sensation, hypopynon

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14
Q

Causes of keratitis

A 
Bacterial -> S.aureus, P.aeriginosa (in contact lens wearers)
Viral -> herpes simplex
Fungal
Amoebic
Parasitic
Photo keratitis -> welding
Contact lenses
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15
Q

Causes of miosis

A 
Horners syndrome
Argyll-Roberston pupil
Senile miosis
Pontine haemorrhage
Congenital
Opiates
Parasympathomimetics -> pilocarpine
Organophosphate toxicity
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16
Q

Causes of mydriasis

A 
3rd nerve palsy
Holmes-Aide pupil
Traumatic iridoplegia
Pheochromocytoma
Congenital
Topical mydratics -> atropine
Sympathomemetics -> amphetamine, cocaine
Anti-cholinergics -> tricyclic anti-depressants
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17
Q

Causes of Argyll-Robertson pupil

A

Diabetes

Neurosyphillis

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18
Q

S+S Argyll-Robertson pupil

A

Small constricted pupil

Accomodation reflex present; pupillart reflex absent

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19
Q

S+S Holmes-Aide pupil

A 
Dilated pupil (usually unilateral)
Slowly reactive to accommodation but very poorly to light
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20
Q

Causes of Marcus-Gunn pupil

A

Retinal detachment

Optic neuritis

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21
Q

S+S Murcus-Gunn pupil

A

Affected eye dilated when light moved to it in swinging light test

22
Q

Fundoscopy features of papilloedema

A 
Venous engorgement
Loss of venous pulsation
Blurring of optic disc
Elevation of optic disc
Loss of optic cup
Paton's lines = Concentric/radial lines cascading from the optic disc
23
Q

Causes of pailloedema

A 
Space occupying lesion -> neoplastic/vascular
Malignant hypertension
Idiopathic intracranial hypertension
Hydrocephalus
Hypercapnia
Hypothyroid
Hypocalcaemia
Vitamin A toxicity
24
Q

Cause of tunnel vision

A 
Papilloedema
Glaucoma
Retinitis pigmentosa
Choroidoretinitis
Optic atrophy secondary to tabes dorsalis
Hysteria
25
Q

What are angioid retinal streaks?

A

Irregular dark streaks radiating from the optic nerve head.

Due to degeneration, calcification and breaks in Bruchs membrane

26
Q

Cause of angioid retinal streaks?

A 
Pseudoxanthoma elasticum
Ehler-Danls syndrome
Pagets disease
Sickle cell anaemia
Acromegaly
27
Q

What is optic atrophy?

A

Pale well demarcated disc on fundoscopy due to optic neuropathy.
Usually bilateral. Associated with gradual loss of vision

28
Q

Acquired causes of optic atrophy

A

MS
Lonstanding papilloedema
Increased intraocular pressure => glaucoma, tumours
Retinal damage => choroiditis, retinitis pigmentosa
Ischaemia
Toxins => tobacco, methanol, arsenic, lead, quinine
Nutritional => B1, B2, B6, B12

29
Q

Congenital causes of optic atrophy

A

Freidrichs ataxia
Mitochondrial => Lebers optic atrophy
DIDMOAD

30
Q

Congenital causes of optic atrophy

A

Freidrichs ataxia
Mitochondrial => Lebers optic atrophy
DIDMOAD

31
Q

S+S optic neuritis

A

Unilateral decrease in visual acuity over hours to days
Poor discrimination of colous => “red desaturation”
Pain worse on eye movement
Relative afferent pupillary defect
Central scotoma

32
Q

Causes of optic neuritis

A

MS
Diabetes
Syphillis

33
Q

Ocular manifestations of RA

A 
Keratoconjunctivitis siccs
Episcleritis
Scleritis
Corneal ulceration
Keratitis
Steroid induced cataracts
Chloroquine retinopathy
34
Q

S+S retinitis pigmentosa

A

Night blindness
Tunnel vision
Fundoscopy = black bone spicule shaped pigmentation of peripheral retina & mottling of retinal pigmented epithelium

35
Q

Conditions associated with retinitis pigmentosa

A 
Usher syndrome
Alports syndrome
Kearns-Sayre syndrome
Abetalipoprotein
Lawrence-Moon-Beidl syndrome
Refsums disease
36
Q

S+S Horners syndrome

A

Miosis
Anhidrosis
Ptosis
Enophthalmos

37
Q

Site of lesion: Horners with anhidrosis of face, arm & trunk

A

Central lesion

38
Q

Site of lesion: Horners with anhidrosis of face

A

Pre-ganglionic

39
Q

Site of lesion: Horners with no anhidrosis

A

Post-ganglionic

40
Q

Central cause of Horners

A 
Stroke 
Syringomyelia
Multiple sclerosis
Tumour
Encephalitis
41
Q

Pre-Ganglionic cause of Horners

A

Pancoast tumour
Trauma
Thyroidectomy
Cervical rib

42
Q

Post-Ganglionic cause of Horners

A

Cavernous sinus thrombosis
Carotid artery dissection
Carotid aneurysm
Cluster headache

43
Q

S+S blepharitis

A

Usually bilateral
Grittiness & discomfort
Erythematous/swollen eyelid margins
Styes and chalazions more common

44
Q

Causes/RF for blepharitis

A

Meibomian gland dysfunction
Seborrhoeic dermatitis
Staphylococcal infection
Rosacea

45
Q

Treatment for blepharitis

A

BD hot compresses

Mechanical removal of debris

46
Q

Causes of cataracts

A 
Age related
Steroids
Smoking
Excess alcohol
Trauma
Diabetes
Radiation/heat exposure
Metabolic disorders
47
Q

Characteristics for dry ARMD

A

Drusen -> yellow spots within Bruch’s membrane

48
Q

Characteristics for wet ARMD

A

Neovascularisation
Leakage of serous fluid
Haemorrhages

49
Q

Investigations for ARMD

A

Slit lamp
Colour fundus photograph
Flourescein angiography
Ocular coherence tomography

50
Q

Treatment for ARMD

A

Anti-oxidant vitamin A,C & E
Anti-VEGF MAb
Laser photocoagulation

MRCP Part 1 (13 decks)

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